2026-04-13T13:45:32Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/105552025-10-24T10:35:01Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
Schuler, Florian
author
Dequatre‐Ponchelle, Nelly
author
Rémi, Jan
author
Dobrocky, Tomas
author
Goeldlin, Martina
author
Ribo, Marc
2025-10-24T10:35:01Z
2025-10-24T10:35:01Z
2023-11-08T09:38:24Z2023-11-08T09:38:24Z2023-10-17
http://hdl.handle.net/11351/10555
Prehospital stroke triage; Reperfusion therapyTriaje prehospitalario de ictus; Terapia de reperfusiónTriatge prehospitalari d'ictus; Teràpia de reperfusióBackground
The RACECAT (Transfer to the Closest Local Stroke Center vs Direct Transfer to Endovascular Stroke Center of Acute Stroke Patients With Suspected Large Vessel Occlusion in the Catalan Territory) trial was the first randomized trial addressing the prehospital triage of acute stroke patients based on the distribution of thrombolysis centers and intervention centers in Catalonia, Spain. The study compared the drip‐and‐ship with the mothership paradigm in regions where a local thrombolysis center can be reached faster than the nearest intervention center (equipoise region). The present study aims to determine the population‐based applicability of the results of the RACECAT study to 4 stroke networks with a different degree of clustering of the intervention centers (clustered, dispersed).
Methods and Results
Stroke networks were compared with regard to transport time saved for thrombolysis (under the drip‐and‐ship approach) and transport time saved for endovascular therapy (under the mothership approach). Population‐based transport times were modeled with a local instance of an openrouteservice server using open data from OpenStreetMap.The fraction of the population in the equipoise region differed substantially between clustered networks (Catalonia, 63.4%; France North, 87.7%) and dispersed networks (Southwest Bavaria, 40.1%; Switzerland, 40.0%). Transport time savings for thrombolysis under the drip‐and‐ship approach were more marked in clustered networks (Catalonia, 29 minutes; France North, 27 minutes) than in dispersed networks (Southwest Bavaria and Switzerland, both 18 minutes).
Conclusions
Infrastructure differences between stroke networks may hamper the applicability of the results of the RACECAT study to other stroke networks with a different distribution of intervention centers. Stroke networks should assess the population densities and hospital type/distribution in the temporal domain before applying prehospital triage algorithms to their specific setting.M.G. has received grants from the Swiss Academy of Medical Sciences/Bangerter‐Rhyner‐Foundation, Swiss Stroke Society, and Mittelbauvereinigung der Universität Bern as well as a congress grant from Pfizer, not related to this project. J.G. reports being global co‐principal investigator of the STAR Study, NCT01327989; consultancy Medtronic; global co‐principal investigator of SWIFT DIRECT, NCT03192332; consultancy Medtronic; principal investigator: Stroke treatment goes personalized: Gaining added diagnostic yield by computer‐assisted treatment selection (the STRAY‐CATS project), Swiss National Funds 170 060. J.K. reports grants from the Swiss Academy of Medical Sciences/Bangerter Foundation, Swiss Stroke Society, and Clinical Trials Unit Bern during the conduct of the study. T.R.M. reports grants from the Swiss Academy of Medical Sciences/Bangerter Foundation, Swiss National Science Society, and Swiss Heart Foundation during the conduct of the study. U.F. reports research grants from Medtronic for the SWIFT DIRECT trial and BEYOND SWIFT registry, Swiss National Science Foundation, Swiss Heart Foundation; consulting fees from Medtronic, Stryker, and CSL Behring (fees paid to institution); membership of a Data Safety Monitoring Board for the IN EXTREMIS trial and TITAN trial and Portola (Alexion), advisory board (fees paid to institution); and vice presidency of the Swiss Neurological Society. The remaining authors have no disclosures to report.
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess
Avaluació de resultats (Assistència sanitària)
Triatge (Medicina)
Malalties cerebrovasculars - Tractament
DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke
Other subheadings::Other subheadings::/therapy
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Drug Therapy::Thrombolytic Therapy
HEALTH CARE::Health Care Facilities, Manpower, and Services::Health Services::Emergency Medical Services::Triage
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome
ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::accidente cerebrovascular
Otros calificadores::Otros calificadores::/terapia
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::farmacoterapia::tratamiento trombolítico
ATENCIÓN DE SALUD::instalaciones, servicios y personal de asistencia sanitaria::servicios de salud::servicios médicos de urgencia::triaje
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento
Geographical Requirements for the Applicability of the Results of the RACECAT Study to Other Stroke Networks
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion